The service’s first phase was originally due to start on January 11 2023, the Pharmaceutical Services Negotiating Committee (PSNC) wrote in a notice to contractors last week (December 16).

But now the national service is “expected to commence in early 2023”, although its “exact start date is yet to be agreed”, it said.

Read more: PSNC unveils plans for new national pharmacy contraception service

PSNC’s director of NHS services, Alastair Buxton, said the negotiator had “sought a delay to the start of the service to allow time for the necessary IT support to be developed”.

This will ensure that contractors who sign up to provide the service “can do so with fully functioning IT to support its delivery”, he added.

However, he said that PNSC does not “expect many pharmacies will have the capacity to provide the service as soon as it commences”, as pharmacy teams “are under massive pressure as a result of patient demand, a funding squeeze and workforce shortages”.

The NHS Business Services Authority (NHSBSA) last week asked suppliers providing software to pharmacies to confirm whether they could meet the criteria and timescales for the delivery of the pharmacy contraception service.

 

Tier one service specification published

 

PSNC also announced that the NHSBSA had published a draft service specification for tier one of the advanced pharmacy contraception service.

Its publication “ahead of the start of the new service provides contractors and their teams with an opportunity to…consider whether it is something they will have the capacity to provide in due course”, Mr Buxton said.

The specification said that tier one of the service aims to establish a model for community pharmacy teams to continue providing oral contraception under a patient group direction (PGD) to patients who were first prescribed it via primary care or sexual health clinics.

It also aims to establish “an integrated pathway between existing services and community pharmacies”.

Under tier two, pharmacists will be able to initiate the supply of oral contraception via a PGD, the document said.

Tier three will involve the “ongoing monitoring and management of repeat long-acting reversible contraception (LARC), excluding intrauterine systems and intrauterine devices”, while the fourth phase will include the initiation of LARCs.

 

Provision requirements

 

Consultations under the service must include a conversation with each patient regarding “alternative and more effective forms of contraception”, the document said.

For combined oral hormonal contraception, pharmacists need a record of the patient’s body mass index (BMI) and a blood pressure measurement to supply a repeat prescription.

Though the specification mandated that only pharmacists can complete the consultations, it said that “a suitably trained pharmacy technician” could take a patient’s blood pressure and BMI before the consultation.

These can also be taken by the pharmacist during the consultation or be self-reported by patients.

Pharmacists can issue repeat prescriptions for oral contraception for up to 12 months, which should be made in line with a patient’s previous supply, according to the document.

If ongoing supply of a patient’s contraceptive is not deemed clinically appropriate, “the pharmacist should explain why this is the case to the person and refer them to their general practice or sexual health clinic (or equivalent) where they were initially provided with oral contraceptives”, it added.

 

Payment and reimbursement

 

Meanwhile, the service specification confirmed that participating pharmacies will receive £18 per consultation and a set-up fee of £900, paid in instalments.

Read more: More than 400k pharmacy blood pressure checks done in 10 months

However, it emphasised that pharmacy contractors delivering related services such as the hypertension case-finding service, which also incorporates a blood pressure clinic measurement, cannot claim twice for the same activity.

Any oral contraceptives supplied will be reimbursed in accordance with the Drug Tariff, it added.

 

Patient eligibility

 

Patients who have commenced their first menstrual cycle and are aged 50 and under are eligible to enrol in the service if they have already been supplied an oral contraceptive by a GP or sexual health clinic.

“People who have had a gap (of any duration in length) in their oral contraception cycle cannot be re-initiated on their original prescription as part of this service,” the document stressed.

Pharmacies participating in the service must respond to anybody requesting a repeat supply of their contraceptive “as soon as is reasonably possible”, it added.

“If the pharmacy is unable to offer a consultation within the time needed to meet the person’s ongoing contraception need, they should be signposted to an alternative pharmacy or other service for a consultation,” it said.

PSNC unveiled plans for a national rollout of the service – which pharmacies first piloted in September 2021 – earlier this year, alongside the outcome of its negotiations for the fourth and fifth years of the five-year community pharmacy contract.

NHS England revealed in October that community pharmacy teams had delivered 1,400 consultations under the contraception service pilot in the year or so since its launch.